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Gluten-Free Diet: What to eat, what to avoid

Gluten-Free Diet
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What is Gluten?

Gluten is a protein present in three grains — rye, wheat and barley. As your teeth sink into a warm bagel or squishy bread, you are experiencing the soft texture that gluten adds to foods (x). This protein is in dozens of products, including pasta and cereals.

You may have heard about a friend avoiding gluten as part of a diet trend. For others, this becomes a way of life due to celiac disease or non-celiac gluten sensitivity. These are three separate reasons for eliminating gluten. But what can you eat? And what should you avoid?

What Can I Eat?

Start with red, ripe strawberries, crunchy carrots and a juicy steak. Luckily, these examples are all safe for people with gluten issues.

  • Vegetables
  • Fruits
  • Meats (check for marinades or sauces)
  • Whole Grains
  • Unprocessed Foods

Fresh fruits and vegetables are a healthy choice for everyone. These options provide your body with essential vitamins and minerals. For folks looking to omit gluten, these are worry-free foods. For celiac patients seeking to increase their intake of fruits and vegetables, it helps to replace the nutrients their bodies were unable to retain.

Meat is another safe option if you purchase ones without added sauces. When you bring it home, add flavor with gluten-free ingredients that you know are safe. Seasoned steak with potatoes and salad exemplifies a mighty meal you can still enjoy while staying symptom-free.

When it comes to whole grains, there are many gluten-free options —amaranth, arrowroot, buckwheat, cornmeal, flax and teff (x). Don’t despair if these suggestions are initially unfamiliar to you. Rice and quinoa are also safe. For baking, there are loads of options including flours made from rice, corn and potatoes (x). Some can be substituted for white or wheat flour in your favorite cookie, cake or brownie recipes.

The last bullet point refers to products without additional additives or fillers. While canning, freezing and packaging can be considered “processing,” we are looking for foods with short ingredient lists. A can of green beans or a bag of frozen broccoli are both tasty options.

What Not to Eat

Modifying your diet is essential when you are dealing with celiac disease or have a gluten sensitivity (x). As trace amounts of gluten can be present in a surprising number of products, reading labels will become second nature.

While we know to eschew wheat, rye and barley are also on the unsafe list. Malt and brewer’s yeast are included there as well. It is commonly known that malt is used to make beer, but it also can be found in candies, hot dogs, sauces and medicines (x). It is located in many products, so please check with a dietitian or a doctor if you are unsure.

Brewer’s yeast has many nutritional benefits and cures several digestive issues, except for people who need to avoid gluten (x). It can be found in some alcoholic drinks and loaves of bread.

Soy is a tricky ingredient (x, x). While soybeans don’t have gluten, soy sauce or soy products can. Thus, soy is present in many dressings, marinades and mixes.

The trickiest part about avoiding gluten may be those “dubious” products. These are items that may have been cross-contaminated in factories by other foods. The box or bag can say “gluten-free,” but it can still contain trace amounts (x).

How to Avoid Gluten

It can be discouraging to see foods eliminated from your shelves, one item after another. Before long, you will quickly learn which companies stick to safe handling measures. Then you can make wise substitutions.

While you explore, look for information on how to keep your kitchen safe. Knives, pans and toasters can contain gluten, so two sets may be necessary. Cookie sheets are another item to consider, as baked-on batter may remain (x). Counters, kitchen sponges, cooktops — all areas of the kitchen need to stay clean and free of crumbs. The same is true about eating at restaurants, so you will need to research your choices.

A current trend at restaurants is to list dishes that are “gluten-free” with a symbol on the menu. This effort is appreciated, but needs to be carefully examined. Cross-contamination can occur among cutlery, pots and pans, cutting boards and dishes. A tiny piece of a whole wheat bun could find its way onto the diner’s plate (x). For some, this minor amount is enough to cause pain, discomfort and additional damage.

Getting advice from a dietitian is vital to maintain health for those affected by gluten. A qualified professional will explain the lifestyle changes that are necessary. An expert will also follow up with patients to check their progress.

Gluten and Celiac Disease

Patients who cannot tolerate gluten deal with many symptoms. Many are GI in nature, including flatulence, diarrhea, constipation and stomach pain. Other symptoms may be harder to connect, like skin rashes or depression. Fatigue and weight loss are also common (x).

While weight loss may sound enticing, it may be a dangerous sign. It may indicate you are not getting enough nutrients from your food.

Celiac disease is more than an allergy — your body cannot process the ingredient and trying to do so causes damage to your small intestine. These patients suffer from a lack of nutrients as the small intestine is unable to absorb these from foods.

While several body parts are associated with digestion, the small intestine is a vital player. Tiny hairs, or villi, absorb the crucial nutrients from our foods. If you have celiac disease, those hairs have been damaged and/or no longer do their jobs (x).

Celiac disease is in the autoimmune category. The immune system tries to fight the gluten, causing internal injury. If untreated, additional harm will be done to your body and can lead to other severe conditions (x). Roughly 1 percent of the American population has celiac disease, which denotes 3 million people (x).

Non-celiac gluten sensitivity presents itself with similar stomach or digestion issues. Damage is not being done to the body, but they suffer from the same constipation, diarrhea or headaches that the others experience. These patients need to avoid gluten, just like celiac patients. This sensitivity is much more common than celiac disease, as it impacts 18 million Americans (x).

One very significant difference is the testing for celiac disease. The first step is bloodwork. If the doctors see any indications of celiac disease, patients are referred for an additional procedure, called an endoscopy (x).

When an endoscopy is performed, a patient is sedated while a tiny camera is inserted orally. This travels down through the stomach, providing a view of the intestines. A small biopsy is taken and examined (x). The results are available within a week, in most cases.

This test examines the small intestine and stomach to determine the damage and seems to be the only reliable indicator of celiac disease. Unfortunately, non-celiac gluten sensitivity is not as easily diagnosed.

As you begin eating differently, you could notice several benefits. Some patients increase to a healthier weight, as their bodies are now retaining nutrients in food. Others notice rashes and skin conditions clear up; many patients realize those side effects were related to the gluten they were formerly consuming (x).

After months on a new routine, you could experience more energy, fewer headaches or a greater appetite. The length of true recovery time varies, although some patients report feeling better after a few weeks.

Gluten-Free Diet and Weight Loss

At times, people choose to avoid gluten to lose weight. There is little evidence to support this idea. However, if we think about the average person’s intake, he or she may consume dozens of items containing gluten in a week.

If one avoids those foods and replaces them with fresh, whole food choices, they could lose weight. If one begins to eat more processed gluten-free items, such as the fresh bread, pasta and cookies that are available, he or she may gain weight. Often, those gluten-free processed foods have extra sugar or fat to add flavor (x). As with all diets, losing weight is dependent on your new habits.

If you want to go gluten-free to shed pounds, plan your meals and snacks. Learn where gluten hides and which alternatives are healthiest. Just like any other diet change, eat less junk, exercise and drink plenty of water (x). The difference involves the effort it takes to find all those hidden sources of this protein.

The Bottom Line

Eliminating gluten from your diet can be a daunting task. Use the experience of your dietitian, health care provider and reputable websites to help you sort through the information. They will also guide you toward a proper diagnosis.

Fruits and vegetables are a healthy addition for everyone, so you cannot go wrong with those choices. You do not need to banish all grains but will need to seek out other varieties. It takes time and effort to replace these food items, and labels are not always entirely correct.

Researching information will be necessary. Your family members can assist with this by looking for new foods for you to try. We are fortunate that more food choices are in development as awareness increases.

A diagnosis of celiac disease or non-celiac sensitivity is difficult to hear. It affects all aspects of your life, and you may become discouraged. In fact, depression is common since many social events involve food; these events can be difficult when you need to stay gluten-free, leading to sadness or depression (x).

Making any change to your lifestyle or diet can have side effects. Always contact your health care provider beforehand and follow his or her recommendations.

By: Miranda Perloff

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Christina Smith


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